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Understanding medication non-adherence in bipolar disorders using a Necessity-Concerns Framework

2008; Elsevier BV; Volume: 116; Issue: 1-2 Linguagem: Inglês

10.1016/j.jad.2008.11.004

1573-2517

Jane Clatworthy, Richard Bowskill, Rhian Parham, Tim Rank, Jan Scott, Rob Horne,

Pharmaceutical studies and practices

Medication non-adherence is a major problem in patients with severe mental disorders and is associated with poor clinical outcomes and high resource utilization. This study examined the utility of the Necessity-Concerns Framework for understanding patient attitudes towards and levels of adherence with medications prescribed for bipolar disorders. A convenience sample of 223 individuals currently prescribed medication for bipolar disorders, recruited by advertisement in a Manic Depression Fellowship newsletter, completed the Beliefs about Medication Questionnaire and the Medication Adherence Report Scale. Low adherence was reported by 30% (n = 64) and was predicted by greater doubts about personal need for treatment (OR = .50; 95% CI: .31–.82) and stronger concerns about potential negative effects (OR = 2.00; 95% CI: 1.20–3.34). These predictors were independent of current mood state, illness and demographic characteristics. Participants were a potentially biased sample of volunteers who had been recruited through a patient organisation newsletter. However, clinical characteristics and adherence rates in this study were similar to those reported in other studies conducted in Europe and the USA. The Necessity-Concerns Framework is a useful theoretical model for understanding key attitudes towards medication in bipolar disorders. Interventions to facilitate adherence should elicit and address patients' beliefs about medication.